Objectives ~ Identify instruments to guide treatment planning ~ Identify the causes of depression ~ Identify behavioral interventions ~ Identify cognitive interventions ~ Identify Emotional Interventions Effects of Depression on Treatment ~ The client with depressive symptoms may have difficulty in any or all of the following areas: ~ Ability to follow instructions and keep appointments. ~ Energy to participate in or maintain interest in program activities. ~ Motivation for change. ~ Ability to make appropriate decisions about treatment needs and goals. ~ Belief that he or she can be helped. ~ Responsiveness to reinforcements. ~ Ability to handle feelings. ~ Ability to handle relations with other clients. ~ Ability to attend to (and not disrupt) group activities. ~ Ability to avoid relapse after treatment is completed.

Causes of Depression ~ What is causing the biochemical imbalance ~ Emotional ~ Depression ~ Lack of pleasure ~ Stress ~ Anger ~ PTSD ~ Fears activating the HPA Axis ~ Abandonment/isolation/rejection ~ Failure ~ Loss of control ~ Emotional dysregulation Emotional Interventions ~ Keep a daily log of nutrition, sleep, things that trigger emotional distress and ways you cope, and share with your counselor to identify patterns, themes and effective interventions ~ Develop a stress management plan ~ Identify methods that help you deal with anger, anxiety and depression ~ Do things that make you happy ~ Address guilt ~ Learn distress tolerance skills to assist in tolerating emotional upset Causes of Depression ~ What is causing the biochemical imbalance ~ Cognitive ~ Cognitive distortions ~ All or nothing ~ Availability heuristic ~ Emotional reasoning ~ Personalization ~ Overgeneralization ~ Jumping to conclusions ~ Magnification and minimization ~ Negative global, stable attributions ~ Extremely internal or external locus of control ~ Ineffective distress tolerance skills ~ Ineffective problem solving skills Addressing Negative Self Talk & Cognitive Distortions ~ Identify the situations that make the client feel uncomfortable. ~ For each uncomfortable situation, make a list of the uncomfortable feelings the client experienced after the situation. ~ Ask the client to identify the first thought that comes to mind when he thinks of the uncomfortable situation. Then identify other thoughts that often arise with this situation. Try to identify a theme from the thoughts. ~ Identify how the thought(s) or theme limits the client’s options in life. ~ Help the client identify different ways of thinking about the situation and feelings that can lead to better options. ~ Once the list of reasonable responses is completed, summarize it, go back through the list of feelings generated for that situation in Step 2, and discuss the decrease in intensity of each feeling for the new list of reasonable responses compared with the feelings related to the old, negative thoughts. ~ Plan for continuing practice of this new skill.

Interventions: Cognitive ~ 5 steps to challenge beliefs that limit options for change: ~ Listen to the client’s organization of and beliefs about the problem ~ Present your understanding of the belief (“It sounds like you believe that..”); see if the client agrees or disagrees with that assessment. ~ If the client disagrees with your assessment of the belief, then ask for a more accurate statement of what he or she believes. ~ If the client agrees with your assessment of the belief, explore how holding that belief affects the client’s ability to address the problem. ~ If the client agrees with your assessment, inquire if he or she would add or change anything about the way you phrased the belief (to be as specific as possible about the belief). ~ Help the client reframe the belief from a truth (unchangeable) to a thought (changeable) ~ Help the client alter beliefs to include options for changing the problem.

Interventions: Cognitive ~ Learn about the connection between thoughts, feelings and actions ~ Identify and address/challenge cognitive distortions with ~ Daily distortions logs ~ Worksheets and videos ~ Learn about attributions and address negative global, stable attributions ~ Keep a log of negative, global, stable attributions and restructure them to be more specific and changeable. ~ Learn about locus of control and how to moderate an extremely internal or external locus of control ~ Keep a log of stressors or things that make you feel helpless and hopeless and identify what parts are within your control and what parts are not. ~ Develop effective problem solving skills based on the problems that trigger your depression (Start by reading 7 Habits) ~ Increase feelings of self-efficacy Causes of Depression ~ What is causing the biochemical imbalance ~ Social ~ Lack of social support ~ Interpersonal conflict (Friends, family, work, social media) ~ Interpersonal losses ~ Ineffective communication skills ~ Poor self-esteem Social Interventions ~ Learn about healthy relationships ~ Identify healthy relationships you currently have ~ Improve self esteem (your relationship with yourself) ~ Identify issues that need to be addressed in current relationships to make them healthy ~ Identify 3 people with whom you could develop a healthy support system ~ Learn skills to handle conflict ~ Learn effective communication skills ~ Learn how to ask for what you need Causes of Depression ~ What is causing the biochemical imbalance ~ Situational ~ Losses ~ Relationships ~ Death ~ Freedom ~ Dreams ~ Sense of order in the world (control/hope) ~ Self-esteem Causes of Depression ~ What is causing the biochemical imbalance ~ Environmental ~ People in the environment ~ Noise ~ Toxins/allergens ~ Sensory overload or deprivation ~ Depression triggers Interventions: Environmental ~ Develop strategies to increase positive people and buffer against negative people in the environment ~ Address noise with white noise machines, ear plugs, talking to roommates ~ Eliminate toxins/allergens that may be making you feel depressed (fresh paint), or keeping you from sleeping well ~ Create a calming corner in your house and at work where there isn’t too much (or too little) stimulation, and there are triggers for happiness Summary ~ Treatment planning needs to be individualized to address: ~ Acute crisis and dangerousness ~ Biomedical conditions and complications ~ Emotional, behavioral or cognitive issues ~ Readiness for change for EACH issue/objective ~ Strengths for addressing each issue ~ Relapse or continued problem potential ~ Stage of readiness for change ~ Recovery environment

AllCEUs started providing affordable CEUs and counseling continuing education, including online ceus and webinar based counseling ceus, in 2006 to help counselors licensed by their state board of professional counseling or state board of alcohol and drug abuse access affordable counselor continuing education, meet their continuing education requirements and enhance their addiction or mental health counseling practice. Since then, other companies have joined the marketplace to provide lpc continuing education including quantumunitsed, ce4less, Aspira aspirace, tzkseminars, i-counseling, accessceu, CEUbynet, pdresources. AllCEUs pioneered the model of offering unlimited CEU packages for a flat rate. We also were the first to offer live webinars each week for $5 per counseling webinar. We pride ourselves on having the largest catalog, with well over 200 multimedia, online counseling CEU courses. AllCEUs is an approved continuing education provider by the Connecticut Certification Board, The Florida Certification Board, FCB, The Alcohol and Drug Abuse Counseling Board of Georgia, ADACB-GA, NAADAC, the association for addiction professionals, the Texas Board of Social Work, The Texas Board of Professional Counseling, The Texas Board of Marriage and Family Therapy, California Consortium of Addiction Programs and Professionals, the Florida Board of Social Work, Mental Health Counseling and Marriage and Family Therapy and many other boards. It is important to note that, in most states, CEUs are NOT required to be NBCC approved, and most states accept ceus which are NOT from an NBCC approved continuing education provider or ACEP. For specific information about which other approval bodies your state accepts, you can visit our approvals page: https://cdn1.allceus.com/wp-content/uploads/2017/01/NewStateApprovalChart2017-1.pdf which provides a summary and links to the documents of the various state licensing boards for counselors, therapists and social workers. For mental health counselors, social workers and marriage and family therapists in Florida, AllCEUs reports your counseling CEUs to CE Broker. Whether you are a LCSW, MSW, LMFT, LMFT LMHC, LPC, LPCC, LCPC, CCMHC, MHC, CADC, LADC, CAP, LCDC, recovery coach, psychotherapist, pastoral counselor, addiction counselor, substance abuse counselor, recovery specialist, behavioral health technician needing mental health or addiction counseling CEUs online, or wanting to get certified as an addiction professional, AllCEUs has a variety of affordable online counseling CEUs, online addiction counselor certificate training tracks and face to face training options. Our unlimited CE packages provide professional counselor continuing education (CEUs) in addiction counseling, transdisciplinary foundations of addiction counseling, screening and assessment, diagnosis, family therapy, pharmacology, psychopharmacology, case management, crisis intervention, counseling tools, dialectical behavior therapy, mindfulness, acceptance and commitment therapy, ethics, supervision, working with adolescents, and many more.